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Pulley Rupture and Reconstruction in Rock Climbers

Moutet, François MD; Forli, Alexandra MD; Voulliaume, Delphine MD

Techniques in Hand & Upper Extremity Surgery: September 2004 - Volume 8 - Issue 3 - p 149-155
doi: 10.1097/01.bth.0000128545.94060.99

Hand-grip techniques in modern rock climbing generate climbing-related injuries, especially at the flexor tendon sheath level. The most frequent injury is A2 pulley rupture. The clinical diagnosis is based on bowstringing of the flexor tendon and confirmed by computed tomograph scan or magnetic resonance imaging. The surgical procedure is based on an extensor retinaculum graft to reconstruct the ruptured pulley. It is the only efficient treatment regardless of the time between accident and surgery. Thanks to this surgical procedure, patients recover or improve their former climbing performance. Some precautions before climbing may prevent this injury, and these are listed.

Hand and Burns Unit

Department of Plastic Surgery

University Joseph Fourrier

Albert Michallon Hospital

Grenoble, France

Address correspondence and reprint requests to François Moutet, MD, Unite de Chirurgie Reparatrice de la Main et des Brules, S.O.S. Main Grenoble, Hôpital A.Michallon-B.P. 217, Chu de Grenoble, 38043 Grenoble Cedex 09, France. E-mail:

© 2004 Lippincott Williams & Wilkins, Inc.